Dental Materials, Department of Oral Dental Diseases, University of Chieti-Italy, Via Vestini 31, 66013, Chieti, Italy.
Lasers Med Sci. 2013 May;28(3):845-9. doi: 10.1007/s10103-012-1174-4. Epub 2012 Jul 28.
The aim of this study is to evaluate the effectiveness of the low-level laser therapy (LLLT) in the control of pain, swelling, and trismus associated with surgical removal of impacted lower third molars. Thirty patients were randomized into two treatment groups, each with 15 patients-group test (LLLT) and a group control (no-LLLT)-and were told to avoid any analgesics 12 h before the procedure. In group test, the 980-nm diode-laser (G-Laser 25 Galbiati, Italy) was applied, using a 600-μm handpiece, intraorally (lingual and vestibular) at 1 cm from the involved area and extraoral at the insertion point of the masseter muscle immediately after surgery and at 24 h. The group control received only routine management. Parameters used for LLLT were: continuous mode, at 300 mW (0.3 W) for a total of 180 s (60 s × 3) (0.3 W × 180 s=54 J). Group test showed improvement in the interincisal opening and remarkable reduction of trismus, swelling and intensity of pain on the first and the seventh postoperative days. Although LLLT has been reported to prevent swelling and trismus following the removal of impacted third molars, some of these studies reported a positive laser effect while others did not. All references to the use of laser therapy in the postoperative management of third molar surgery employ different methodologies and, in some, explanations as to selection of their respective radiation parameters are not given. This study has demonstrated that LLLT, with these parameters, is useful for the reduction of postoperative discomfort after third-molar surgery.
本研究旨在评估低水平激光疗法(LLLT)在控制与下颌第三磨牙阻生牙切除相关的疼痛、肿胀和牙关紧闭方面的有效性。30 名患者被随机分为两组,每组 15 名患者-实验组(LLLT)和对照组(无 LLLT)-并被告知在手术前 12 小时避免使用任何止痛药。实验组中,使用 980nm 二极管激光(G-Laser 25 Galbiati,意大利),通过一个 600μm 的手柄,在口腔内(舌侧和颊侧)距受累区域 1cm 处和口腔外的咬肌插入点处进行治疗,在手术后即刻和 24 小时进行治疗。对照组仅接受常规治疗。LLLT 采用连续模式,总能量为 54J(300mW×180s),其中 60s×3,能量密度为 0.3W。实验组的切牙间开口度改善,术后第 1 天和第 7 天的牙关紧闭、肿胀和疼痛强度显著减轻。虽然已经有报道称 LLLT 可以预防阻生第三磨牙切除术后的肿胀和牙关紧闭,但其中一些研究报告了激光的积极效果,而另一些则没有。所有关于激光治疗在第三磨牙手术后管理中的应用的参考文献都采用了不同的方法,在某些情况下,没有给出其各自辐射参数的选择的解释。本研究表明,采用这些参数的 LLLT 可有效减轻第三磨牙手术后的术后不适。